Substance Abuse and Treatment Program Block Grant Program, HIV Early Intervention Services, 2009
Florida
AIDS Rate per 100,000
27.3*
State Funds for HIV Early Intervention Services
State Expenditures
Required Base SFY 2008 Expenditures Maintenance
$0 $0
SAPT EXPENDITURES
FY 2006 HIV Set-Aside FY 2009 Planned
$4,715,868 $4,905,126
FY 2010 SAPT Reports
Florida contracts with substance abuse providers to provide HIV early intervention services. Services provided
include pre/post test counseling, HIV rapid testing, stress management, risk reduction/behavioral change
strategies, health promotion, case management, outreach linkages.
HIV Early Intervention Services Provided
Rapid Funding Regular Pre-Test Referral Risk HIV/AIDS Outreach
Testing Rapid HIV and Post- Services Assessment Education
Testing Testing Test
Counseling
√ √ √ √ √ √ √
State Narrative Summary
In FY 2006-2007, Florida discharged 16,013 individuals from substance abuse treatment who received HIV
Early Intervention Services. Among individuals receiving any type of substance abuse service (treatment or
non-treatment) 26,294 received HIV education and 9,669 received HIV tests. The range of HIV services
included client education, screening and pre and post HIV test counseling, mandatory offering of confidential
HIV testing (blood draw, Ora Sure Saliva and rapid testing), and linkage and case management for any
therapeutic measures needed by HIV positive individuals. Forty-one substance abuse treatment providers
under contract with the State provided HIV Early Intervention Services. Additionally, contracted substance
abuse agencies provided 24,305 outreach contacts and 3,403 HIV tests to substance abusing individuals in the
community. The SSA worked with the State Department of Health to coordinate and conduct a five-part
series of collaborative cross-trainings statewide as additional support for this initiative.
*THE MOST RECENT DATA PUBLISHED PRIOR TO OCTOBER 1, 2008 BY THE CDC IS TABLE 14, REPORTED AIDS CASES AND ANNUAL RATES (PER
100,000 POPULATION), BY AREA OF RESIDENCE AND AGE CATEGORY, CUMULATIVE THROUGH 2005-UNITED STATES, HIV/AIDS SURVEILLANCE
REPORT 2005 VOL. 17, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL
CENTER FOR HIV, STD, AND TB PREVENTION, DIVISION OF HIV/AIDS, PREVENTION, SURVEILLANCE, AND EPIDEMIOLOGY. SINGLE COPIES OF
THE REPORT ARE AVAILABLE THROUGH THE CDC NATIONAL PREVENTION INFORMATION NETWORK, 800-458-5231 OR 301-562-1098 OR
HTTP://WWW.CDC.GOV/HIV/TOPICS/SURVEILLANCE/RESOURCES/REPORTS/2006REPORT/TABLE14.HTM.
Florida page 1/9
Full State Narrative
FY 2006 (COMPLIANCE)
Florida's Department of Health epidemiological data for HIV/AIDS cases at the county level were used to
determine the allocation of the set-aside funds. The total number of HIV/AIDS cases by county were was
totaled by SPA to determine Florida's allocation methodology among geographic areas with funds allocated
based on the SPAs’ percent of total HIV/AIDS cases in Florida. This is updated every three years. All regions
of the state received set-aside funds and most rural areas that have substance abuse treatment services also
have HIV Early Intervention Services.
There were 41 substance abuse treatment providers in SFY 2005-06 under contract to provide HIV Early
Intervention Services. 17,572 individuals in substance abuse treatment received some HIV services and
13,494 received HIV Early Intervention Services, with 5,243 of these reported as receiving actual HIV test,
and 28,770 received HIV educational services.
These services are located at the substance abuse treatment site and are designed to provide the core
program model prescribed in 45 CFR Part 96.128. Florida's model also incorporates bereavement issues,
stress management, risk reduction/behavioral change strategies, nutritional strategies, health promotion, case
management, outreach linkages and quality of life improvement for individuals identified as HIV positive or
living with AIDS. Services were provided on a voluntary basis to all willing clients admitted for treatment in
those provider agencies. These are designated as “Confidential Test Sites” by the Florida Department of
Health.
Reports of individuals discharged during 2006-07 from the statewide Substance Abuse and Mental Health data
warehouse indicate the number of people in treatment who received HIV services:
• HIV Early Intervention Services – 16,013 (9,653 males/6,360 females)
• HIV Education – 26,294 (16,484 males /9,809 females
• HIV Tests – 9,669 (5,547 males/4,122 females)
• TB Services – 11,490 (7,308 males/4,182 females)
• TB Tests – 9,157 (5,896 males/3,261 females)
In 2006-07, annual block grant reports for HIV Early Intervention Service projects were collected for the first
time in the online Survey Monkey. Information about the program and services provided were solicited, as
well as self report confirmation of compliance with HIV Early Intervention Program requirements. Highlights
of results are:
• 35,598 risk assessments were provided.
• 3,365 individuals refused to be tested (9.45% of those screened).
• 271 individuals self reported as HIV positive (.76% of those tested).
• 13,982 individuals were tested for HIV (39% of individuals screened).
• 240 individuals tested positive for HIV (1.72% of individuals tested).
• 11,179 received post test counseling (80% of individuals tested).
• 2,939 individuals were referred or linked to AIDS organizations or county public health for
additional HIV, infectious disease, or health services.
Substance abuse provider model contract requires compliance with HIV Early Intervention Services
requirements of the block grant. SPA staff monitor all providers who receive block grant funds to ensure
compliance. Discharge reports in the Florida One Family Substance Abuse and Mental Health Statewide Data
Florida page 2/9
System document HIV Early Intervention Services provided by client. Data about actual test results can be
obtained from the Florida Department of Health for Drug Treatment sites using the state lab and for the
number who test positive for HIV. These are periodically monitored.
Efforts continued to support strong collaboration with the Florida Department of Health to address provider
training needs, and to plan for improved HIV/AIDS prevention and intervention, The provider network of HIV
Early Intervention programs was regularly informed and involved in statewide major events and initiatives
coordinated by the State Health Office, Bureau of HIV/AIDS. These providers work with local HIV/AIDS
prevention and Ryan White providers in the community on event such as World AIDS Day (December 1
annually), National Black AIDS Awareness Day (February 7 annually), National Latino AIDS Awareness Day
(October 15 annually), and National HIV Testing Day (June).
In 2006, the Substance Abuse Program Office participated with the Florida Dept. of Health in coordinating and
conducting a five-part series of collaboration cross trainings throughout the state, supported through the
SAMHSA funded technical assistance project. In addition to the wealth of special HIV/AIDS trainings offered
through various venues throughout the state, during the Fall 2006 Florida Alcohol and Drug Abuse Conference,
the State Health Office provided special trainings and sessions related to HIV/AIDS, TB and Hepatitis.
In 2005-06, Florida continued its Memorandum of Agreement (MOA) with the Florida Department of Health to
provide administrative support, data collection, site certification and training for HIV Rapid Testing in 17
targeted sites. $20 thousand of the HIV Early Intervention set-aside funds support this effort with the Dept of
Health providing substantial leveraged technical expertise and staff support for this initiative.
FY 2008 (PROGRESS)
The state continued the baseline allocation to geographic areas. 41 providers were funded in 2007-08 for HIV
Early Intervention Projects throughout the state. Substance abuse provider model contract require compliance
with HIV/AIDS requirements of the block grant. SPA staff monitor all providers who receive block grant funds
to ensure compliance. No compliance problems were identified.
Allocations by region are as follows:
Northwest $159,808
Northeast $428,730
Central $748,012
Suncoast $720,942
Southeast $1,186,357
Southern $1,308,756
All HIV Early Intervention (EI)sites continued to be offered the opportunity to implement HIV Rapid Testing
and those sites who indicated an interest were provided with technical assistance and support. In 2006-07,
the state decided to opt out of the SAMHSA Rapid Testing Initiative, given associated workload issues for both
the state and participating providers, combined with the lack of availability of additional free rapid test kits.
However, during 2006-07 and 2007-08, the state continued to provide support for the 17 existing sites
providing rapid testing. These included a mix of HIV Early Intervention Project sites, Substance Abuse IDU
outreach projects, and SAMSHA grantee projects. Ten of the HIV Early Intervention Projects provided HIV
Rapid Testing, and several others obtained Rapid Testing training with plans to possibly begin this administer
this type test in the future.
Florida page 3/9
All of the HIV Early Intervention Projects also offer OraSure saliva tests, with the exception of one Rapid Test
site. Some providers report use of Western Blot confirmation for blood specimens and Enzyme
Immunosorbent Assay (EIA). During 2006-07, the state health lab provided test kits, lab analysis and results
free of charge to all of these projects, using federal grant monies to the Florida Department of Health, Bureau
of HIV/AIDS. All of the HIV EI projects are confidential sites, and eight sites offer anonymous testing also.
Projects staffing ranges from 11 (Suncoast substance abuse network provider and South Florida Network
provider) to one staff person for many providers in the state. HIV risk assessments are provided either as a
part of the initial treatment provider assessment for admission, as a separate assessment, or both for most
providers. Most of these project report provision of the expanded model for extra counseling services, and
one Miami provider additionally reports participation in clinical HIV/AIDS trials.
The Department of Health provided these sites with Rapid Test Kits from State Health’s resources because the
current sites are designated as high priority sites by health. No HIV Early Intervention provider that is
interested in implementing rapid testing and that is willing to comply with related requirements will be denied.
Thus, the state continues to be committed to implementation of rapid testing in strategic areas when
providers are willing to participate. Many providers, however, are content with OraSure salvia tests for clients
who are in ongoing treatment. Strategies for continued long-term funding for the rapid test kits are being
explored with consideration for paying for these tests out of Florida’s HIV Early Intervention set-aside from the
SAPTBG.
In addition to the wealth of special HIV/AIDS trainings offered through various venues throughout the state,
the State Health Office provided an optional preconference day related to HIV /AIDS during the annual Florida
Alcohol and Drug Abuse Conference which occurred August 22-24, 2007. This included a session on HIV Risk
and Testing Behaviors among Injecting Drug Users.
The Florida State Health Office continued to participate with the State Substance Abuse Program Office liaison
in the in the quarterly conference calls of state HIV/AIDS coordinators facilitated by the National Association of
State Alcohol and Drug Abuse Directors.
The Florida HIV/AIDS Community Planning Group included a substance abuse consumer or specialized worker
as an at large member representing special substance abuse interest in development of the states HIV/AID
Prevention Plan. This plan continued to include substance abusers as six of its 13 priority populations for
intervention: white, black and Hispanic injecting drug users and injecting drug users/male sex male.
Requirements related to HIV Early Intervention Services were evaluated as a part of Florida’s FY 2007-08
(February 2008) Core Technical Review of the Florida Substance Abuse Program Office (SAPO) conducted by
JBS International, Inc., under contract with the Substance Abuse and Mental Health Services Administration
(SAMHSA) Center for Substance Abuse Treatment (CSAT). No issues related to Florida compliance with
assurances required under Goal 6 of this application were identified, except for request for clarification
regarding the MOE requirement. Florida responded with clarification that Florida has never used non-federal
funds to support HIV Early Intervention Services at substance abuse treatment provider sites.
FY 2009 (INTENDED USE)
Goal: To provide treatment for persons with substance abuse problems with an emphasis in making available
within existing programs HIV Early Intervention Services in areas of the state that have the greatest need for
such services and to monitor such service delivery.
Objective: Treatment for persons with substance abuse problems will be provided with an emphasis on
making available HIV Early Intervention Services to the majority of individuals who enter DCF contracted
substance abuse treatment programs in Florida. These programs will be located in all circuits of the
department and will be available through all of Florida’s large providers of substance abuse treatment under
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contract with the DCF. The service delivery system will be monitored utilizing a monitoring tool that
incorporates the guidelines in 45 C.F.R. 96.128, annual reports by HIV Early Intervention Service providers,
and provider data submitted to the Substance Abuse and Mental Health Data Warehouse.
Activities:
• Continue to update the funding allocation methodology for HIV Early Intervention services
to ensure that funding is included in all of the newly created department circuits based on
most recent information about the number of HIV/AIDS cases in each circuit. Provide circuit
with county HIV/AIDS prevelance to consider when making funding/contract allocation
within the circuit’s geographic area.
• Monitor federal block grant compliance, compliance with state HIV/AIDS statutes,
regulations and guidelines through contract monitoring and annual provider reports.
• Analyze data on HIV Early Intervention services provided and HIV test results.
• Continue to coordinate with the Florida Department of Health to ensure provision of
AIDS/HIV/TB services in compliance with rules, regulations and guidelines, specifically:
o Identify educational/training resources and events for providers, facilitate provision
of appropriate education, and notify providers when education and training will
occur.
o Encourage networking between the local agencies that serve the HIV and substance
abuse population.
o Continue to coordinate with the Florida Department of Health, Bureau of HIV/AIDS,
to identify issues and progress in substance abuse treatment provider performance
for HIV counseling and testing, specifically focusing on the HIV Rapid Testing
implementation in 17 targeted Substance Abuse program sites.
o Continue to invite the Florida Department of Health, Bureau of HIV/AIDS to
participate with the state Substance Abuse Program Office liaison in the National
Association of State Alcohol and Drug Abuse Directors’ conference calls and email list
serve for Substance Abuse HIV/AIDS Program Coordinators.
o Participate in the Corrections Infectious Disease workgroup facilitated by the Florida
Department of Health, Bureau of HIV/AIDS, and disseminate relevant information
from that workgroup to substance abuse treatment providers providing HIV/AIDS
services.
HIV Early Intervention Services
All clients receiving Department of Children & Families contracted substance abuse treatment services must be
provided with HIV risk assessments and referrals to public health or private providers if in house capacity does
not exist for HIV testing. However, most of the substance abuse providers under contract with the Department
have capacity to test for HIV, either rapid testing, OraSure salvia tests, or traditional testing using blood
draws.
In FY 2005-06 and 2006-07, all of Florida's SPAs received early intervention set-aside funds to implement
services which target intravenous drug users and others at high risk for HIV/AIDS. In 2005-06, there were 41
service providers under contract with the Department providing HIV Early Intervention Services.
Department of Health epidemiological data of AIDS cases were used to determine the allocation of the set-
aside funds. The most recent prevalence rate of individuals living with HIV/AIDS from each county was
Florida page 5/9
calculated and subtotaled for each SPA, then calculated as a percentage of the statewide total. This
determined Florida's funding allocation methodology among geographic areas/SPAs. Thus, funds are allocated
to each SPA as a percentage of the total people in the state living with HIV/AIDS. This replaced the previous
allocation methodology that relied exclusively on the cumulative prior 3-year AIDS rate to determine relative
need. Mandatory HIV name reporting has been in place in Florida long enough now that new HIV infections
are routinely reported and included in Health epidemiological data.
Maintenance of effort for HIV Early Intervention Services - The MOE for HIV Early Intervention is related to
non-federal expenditures. In Florida, non-federal funds have never supported HIV Early Intervention Services
as HIV EI projects are defined in the federal law and interim final rule. Therefore, there is no non-federal
funding amount to maintain and no dollar amount is specified for the MOE for HIV Early Intervention Services
in Florida.
In 2005-06, according to discharge reports in the SAMH data system, 17,572 clients received HIV Early
Intervention Services and 28,770 received HIV educational services. HIV Early Intervention was selected as a
service provided to 28 percent of all discharges, and discharge reports indicate that 13 percent of whites and
17 percent of blacks received HIV tests. Of those clients discharged in 2006-07: 16,013 (9,653 males/ 6,360
females) received HIV Early Intervention Services; 26,294 (16,484 males/ 9,809 females) received HIV
Education; 9,669 (5,457 males/4,122 females) received HIV Tests.
Additional data reported through HIV Early Intervention Project annual reports are included under 2006
compliance for Goal 6: HIV Early Intervention.
Over six thousand HIV Rapid Tests were reported through these same providers and SAMSHA grantee sites
during this same period through the State Health data base. Information from this data base indicate that the
HIV positive rate in HIV Early Intervention sites tends to be similar to the rate reported through State Health
sites; some years the rate is lower and some higher. For example, in 2002 the positivity rate from Health
sites was 2.3% and from Substance Abuse HIV Early Intervention sites was 2.7%. Yet, in 2004, the positivity
rate from Health sites was 1.9% and from Substance Abuse HIV Early Intervention sites was 1.3%.
These services are located at the substance abuse treatment sites and are designed to provide the core
program model prescribed in 45 CFR Part 96.128. Florida’s model approved through prior block grant
applications also allows for expanded counseling and case management services for individuals identified as
HIV positive or living with AIDS. HIV Early Intervention Services are available to most clients served in
treatment, and if not contracted to a specific agency, at minimum, HIV counseling and testing services are
provided by referral to public county health units. This is the Florida Model for HIV Early Intervention Projects.
Testing Services:
• HIV testing
• Confirmation testing
• Diagnostic Services
• Diagnosing immune system deficiency
• Therapeutic measures Counseling
• HIV pre/test counseling
• HIV post/test counseling
• Bereavement issues
• Stress management
• Risk reduction/behavioral change
• Nutritional strategies/health promotion
• Quality of life improvement
Florida page 6/9
• Case management related to HIV/AIDS
While maintaining the integrity of the HIV Early Intervention Project at the site of the treatment provider, in
high HIV prevalence area of the state, the IDU Outreach is sometimes conducted by some of the same staff
that provide HIV Early Intervention to clients in treatment. Outreach services are required to be provided, at
minimum, by a lead provider on behalf of all the treatment service providers serving IDUs in a designated
geographic area. If the outreach program does not provide HIV testing, the client may be referred to the HIV
Early Intervention Program for HIV pre- and post- test counseling and testing, or referred to the county public
health unit. This is handled differently among providers throughout the state, primarily contingent on the
funding and capacity of the HIV Early Intervention Projects. If HIV is identified either through self report or
test results, the outreach staff would coordinate linkage with HIV service providers on behalf of the client.
Commitment to client and staff HIV/AIDS education is reinforced though the substance abuse licensure rule.
An HIV/AIDS confirmation is required of all licensed substance abuse treatment providers affirming that all
employees of the agency have completed within six months of hire the basic 2 hour HIV/AIDS education
course required by the DCFS, and affirming that they will receive a two hour update biannually. The
confirmation also requires affirmation that age and culturally appropriate HIV/AIDS education will be provided
to persons receiving services based on educational, cognitive, and other levels of functioning. Such courses
must encompass modes of transmission, infection control procedures, clinical management, and prevention of
HIV/AIDS, with emphasis on appropriate behavior and attitude change. Current Florida law and its impact on
testing, confidentiality of test results, and treatment of patients must be addressed.
The Substance Abuse Program Office worked closely with the Florida Department of Health in implementing
rapid HIV testing in targeted areas of the state through HIV Early Intervention Block Grant funded and
SAMHSA funded sites. As of April 30, 2006, the SAMHSA RHTI providers had conducted over 6,850 rapid HIV
tests with 114 reactive test results for a positivity rate of 1.6%.
HIV Early Intervention Programs Receiving Funds
Program Status Address Phone Funds
Department of Children and A Fort Pierce Regional Service Center, 772-467-5523 $21,345
Families Substance Abuse and 337 North 4th Street, Suite A, Fort
Mental Health Programs, Pierce, FL 34950
District 15
Catholic Charities of Central U 3510 Biscayne Boulevard, 3rd Floor, 305-576-1234 $2,845
Florida Miami, FL 33137
CARE Community AIDS U 3510 Biscayne Boulevard, 3rd Floor, 305-576-1234 $35,525
Resource Miami, FL 33137
Substance Abuse and Mental A 1317 Winewood Boulevard, Building 850-921-8461 $2,396,926
Health Program Offices, 6 Floors 2 and 3, Tallahassee, FL
District 80 32399
Lakeview Center, Outpatient A 1221 West Lakeview Avenue, 850-432-1222 $39,881
Counseling Services Building H, Pensacola, FL 32501
Broward County Elderly & A 115 South Andrews Avenue, Room 954-537-2936 $28,530
Florida page 7/9
Veterans Services 516, Fort Lauderdale, FL 33334
Specialized Treatment A 1033 North Pine Hills Road, Suite 300, 407-522-2144 $222,420
Education and Prevention Orlando, FL 32808
Services, The Center for Drug-
Free Living
St. Johns County Health and A 1955 US 1 South, Suite C-2, Saint 904-209-6001 $5,519
Human Services Augustine, FL 32086
The Jessie Trice Community A 1775 NW 60th Street, Miami, FL 305-836-0080 $1,593
Health Center 33142
Care Center for Mental A 1205 4th Street, Key West, FL 33040 305-292-6843 $3,222
Health
Chemical Addictions Recovery A 4000 East 3rd Street, Panama City, FL 850-872-7676 $20,231
Effort 32402
Covenant House Addictions A 733 Breakers Avenue, Fort 954-568-7939 $38,775
Management Project Lauderdale, FL 33304
DISC Village Adolescent A 2967 Natural Bridge Road, 850-421-4115 $12,897
Treatment Program Tallahassee, FL 32305
Drug Abuse Foundation of A 400 South Swinton Avenue, Delray 561-732-0800 $109,344
Palm Beach County Intensive Beach, FL 33444
Residential Program
Eckerd Youth Alternatives, A 397 Culbreath Road, Brooksville, FL 352-796-9493 $1,055
Eckerd Academy at 34602
Brooksville
Gateway Community Services U 555 Stockton Street, Jacksonville, FL 904-387-4661 $13,922
32204
House of Hope & Stepping A 908 SW 1st Street, Fort Lauderdale, 954-524-8989 $83,347
Stones FL 33312
Meridian Behavioral A 439 SW Michigan Street, Lake City, FL 352-374-5600 $80,719
Healthcare, Columbia 32025
Counseling Center
Restoration House Life A 609 North 7th Street, Fort Pierce, FL 772-468-7900 $19,662
Restoration Ministries 34950
River Region Human Services A 660 Park Street, Jacksonville, FL 904-359-2680 $69,179
Florida page 8/9
32204
Southwest Florida Addiction A 3763 Evans Avenue, Fort Myers, FL 239-332-6937 $19,608
Services Outpatient Care 33901
Spectrum Programs Adult A 450 East Atlantic Boulevard, 954-580-0770 $56,346
Residential Services Broward Pompano Beach, FL 33060
Substance Abuse and Mental A 111 South Sapodilla Avenue, West 561-540-5660 $37,590
Health Program Office, Palm Beach, FL 33401
District 9
Tri County TEC Counseling & A Stuart, FL 34995 772-221-4050 $17,840
Recovery Center
Village South A 400 NE 31st Street, Miami, FL 33137 305-573-3784 $14,549
Status Key: [A] Active, [I] Inactive, [n/a] Not available, [P] Facility physically closed, [S] No substance abuse
services provided, [U] Closed as duplicate of another facility.
Florida page 9/9